Many children with ADHD can be taught in a regular classroom with minor adjustments to the environment, but some children require additional assistance using special educational services, especially if they have complex learning difficulties.
Treatment for adults with ADHD involves medical intervention and psychotherapy. Psychotherapy is important because adults with ADHD need to be helped to understand that their educational, vocational and/or personal difficulties are not the result of an irremediable personality flaw.
Between 70-80 percent of children with ADHD respond positively to these medications. Attention span, impulsivity and on-task behaviour improve, especially in structured environments. Some children also demonstrate improvements in frustration, tolerance and compliance levels, even handwriting, as it can assist with fine-motor control and visual-motor co-ordination. Relationships with parents, peers and teachers may also improve.
Medication can also be effective in adults who have ADHD. The reaction to these medications can be similar to that experienced by children with ADHD – a decrease in impulsivity and an increase in attention. Many ADHD adults treated with a stimulant medication report that they are able to bring more control and organisation to their lives.
Medical management of ADHD involves medication that has an influence on the neurotransmitters involved:
1. Stimulants: methylphenidate 
2. Non-stimulants: (a) atomoxetine; (b) tricyclics 
MPH acts immediately when taken, and the effect disappears when serum levels drop. Different preparations and release forms thus lead to a choice of medications with a difference in the period of efficacy.
•    Ritalin IR 10mg 4 hours (a generic is available) 
•    Ritalin LA 20/ 30/ 40 mg 8 hours 
•    Concerta 18/ 27/ 36/ 54 mg 12 hours  (this dose is sometimes increased to 72/ 90 mg in adults)
There is a wide variation in response to dosage of medication, so the appropriate dose needs to be carefully determined for each individual. This is achieved through a medication trail, which begins with a low dose that is gradually increased until clinical benefits are achieved.
Some children experience a negative mood or an increase in activity (rebound) when the effect of the medication is beginning to wear off. This problem can usually be remedied by using a sustained-release form of medication. This allows the medication to be released at a steady rate, so that the level of medication in the bloodstream does not rise and fall to the same extent as it does with the ordinary form of medication. There is a small subgroup in which a consistent negative mood and, at times, an increase of anxiety levels may lead to the use of alternative medication for ADHD.
The use of stimulant medications can, initially, cause a slight decrease in the height and weight of some children, but research suggests that the ultimate height and weight are not affected. Concerns regarding the possible cardiac effects of MPH have led to an extensive review. At present there are no increased clinical concerns. In patients with cardiac problems, the use of stimulants is not advocated.
In patients with tic disorders use of a stimulant may improve tics in a third, worsen tics in a third, or make no difference.
Atomoxetine has a clinical effect that lasts for 24 hours. Its effect takes 6-8 weeks to develop and medication needs to be taken consistently on a daily basis after a meal. Dosage is 1.2-1.8 mg per kg and incremental increases are suggested in the first two weeks. Atomoxetine 10/ 18/ 25/ 40/ 60/ 80 mg is available. A very small subgroup may be poor metabolisers and a lower dose may be used.
Concerns about hepatic effects have proven to be of little clinical concern, as has a possibility of increased suicidality.
Individual dosages need to be determined per patient. It has a 24-hour action and thus is taken once daily. Tofranil is available as 10/ 25 mg tablets.
Tricyclics are used infrequently in ADHD, but may be indicated if contraindications to the other medications exist, if there are unacceptable side effects, or other medications prove to be ineffective.
In other words, ADHD is a condition that can have a negative impact on a range of long-term life skills. 
The good news is that early identification and treatment increases the likelihood of a positive long-term outcome. 
• Inquisitive, exploratory, and open to new experiences
• Active and energetic
• Enthusiastic, spontaneous, and keen to try out new things
• Entertaining and interesting to talk to and be with
With proper treatment in the form of cognitive/behavioural therapy, medication, occupational therapy, exercise, good nutrition and, possibly, alternative therapies, your child’s future looks bright. 
ADHD Expert
Dr. Shabeer Ahmed Jeeva is a specialist psychiatrist who has been practicing child and adult psychiatry for 30 years. He has vast experience in treating ADHD, and is also an ADHD patient himself. Dr. Jeeva trained and practiced in Canada as a child and adult psychiatrist and had lived there for 25 years. He had attended medical school at the Royal College of Surgeons in Dublin, Ireland (1970-1976). His professional experience and accreditation includes: Psychiatric residency at the University of Ottawa (Canada), Child Psychiatry fellowship at the University of Ottawa (Canada), Diploma in Psychiatry at the University of Ottawa (Canada), and Fellow of the Royal College of Physicians in Canada. Visit his website at:
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